Breast Cancer and Reconstructive Surgery Department, The Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Roentgena 5 Str 02-781, Warsaw, Poland.
Eur J Surg Oncol. 2011 Jul;37(7):635-42. doi: 10.1016/j.ejso.2011.05.002. Epub 2011 Jun 12.
To perform a comprehensive analysis of patients with breast cancer and solitary or single brain metastasis and to analyze factors influencing survival from brain metastasis.
One hundred consecutive patients with single or solitary brain metastasis were treated in one institution in the years 2003-2009. Brain lesions were diagnosed by magnetic resonance imaging (MRI). A total of 57% of patients underwent resection of brain metastasis, 95% of patients received whole-brain radiation therapy (WBRT) and 67% were treated systemically after WBRT.
Median survival from the detection of brain metastasis was 13 months and 28% of patients survived for 2 years. In 29 patients with solitary brain metastasis, median survival was 20 months (2-80 months) and in 71 patients with single brain metastasis it was 11 months (1-79 months) p = 0.01. Median survival from brain metastasis in patients with Recursive Partitioning Analysis Radiation Therapy Oncology Group (RPA RTOG) prognostic class I, II and III was 22 months (4-80 months), 13 months (2-79 months) and 6 months (0.4-28 months), respectively, p < 0.0001. Median survival from brain metastasis in triple-negative, HER2, luminal B and luminal A subtypes was 11 months, 13 months, 16 months and 15 months, respectively (p = 0.60). Multivariate analysis revealed that RPA RTOG prognostic class I, neurosurgery and systemic therapy after WBRT were factors that correlated with survival.
In patients with one metastatic lesion in the brain, affiliation to RPA RTOG prognostic class I and intensive local and systemic treatment had a strong correlation with survival. There was no significant correlation between biological subtype of cancer and survival.
对乳腺癌伴单发或单灶脑转移患者进行全面分析，并分析影响脑转移生存的因素。
在 2003 年至 2009 年期间，一家机构对 100 例单发或单灶脑转移患者进行了治疗。脑部病变通过磁共振成像（MRI）诊断。57%的患者行脑转移灶切除术，95%的患者接受全脑放疗（WBRT），67%的患者在 WBRT 后行全身治疗。
从脑转移检测到的中位生存时间为 13 个月，28%的患者存活 2 年。在 29 例单发脑转移患者中，中位生存时间为 20 个月（2-80 个月），71 例单发脑转移患者为 11 个月（1-79 个月），p=0.01。RPA-RTOG 预后分类 I、II 和 III 级患者的脑转移中位生存时间分别为 22 个月（4-80 个月）、13 个月（2-79 个月）和 6 个月（0.4-28 个月），p<0.0001。三阴性、HER2、Luminal B 和 Luminal A 亚型患者的脑转移中位生存时间分别为 11 个月、13 个月、16 个月和 15 个月，p=0.60。多变量分析显示，RPA-RTOG 预后分类 I、神经外科手术和 WBRT 后全身治疗是与生存相关的因素。
对于脑内单发转移病灶的患者，RPA-RTOG 预后分类 I、强化局部和全身治疗与生存密切相关。肿瘤生物学亚型与生存无显著相关性。
